Yıl: 2022 Cilt: 53 Sayı: 4 Sayfa Aralığı: 207 - 212 Metin Dili: İngilizce DOI: 10.14744/zkmj.2022.24865 İndeks Tarihi: 15-05-2023

Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye

Öz:
Objective: The aim of this study was to determine the reference ranges of second trimester nasal bone length (NBL), pre-nasal thickness (PT), and PT/NBL ratios of low- risk pregnant women in Turkish population. Material and Methods: Pregnant women of 16–28th gestational age who underwent ultrasonographic fetal screening between November 2021 and June 2022 were ret- rospectively analyzed. Fetuses with congenital malformations, high risk in antenatal screening tests, diagnosed with aneuploidy, and pregnant women of non-Turkish ethnic origin were excluded from the study. Fetuses were classified as ≤19+6 weeks, 20+0–20+6 weeks, 21+0–21+6 weeks, 22+0–22+6 weeks, 23+0–23+6 weeks, and ≥24+0 weeks. NBL, PT, and PT/NBL ratio was evaluated for each gestational age separately. Results: A total of 242 fetuses were included in the study. The mean NBL and mean PT increased with gestational age (6.42±0.65 at 20+0–20+6 weeks versus 7.65±0.79 at 23+0–23+6 weeks and 3.10±0.62 at 20+0–20+6 weeks vs. 3.55±0.63 at 23+0–23+6 weeks, respectively). Both NBL and PT were positively correlated with gestational age whereas the PT/NBL ratio was constant throughout the second trimester (PCC=0.81, p<0.001, PCC=0.56, p<0.001, and PCC=−0.07, p=0.255, respectively). The mean PT/NBL ratio in the second trimester was calculated as 0.46 (95% CI, 0.45–0.47, 5th p=0.35 and 95th p=0.62). Conclusion: The reference ranges for NBL, PT, and PT/NBL ratio may vary in differ- ent populations. Therefore, the use of population-specific nomograms may lead to higher success rates in Down syndrome screening.
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  • 1. Irving C, Basu A, Richmond S, Burn J, Wren C. Twenty-year trends in prevalence and survival of Down syndrome. Eur J Hum Genet 2008;16:1336–40.
  • 2. Loane M, Morris JK, Addor MC, Arriola L, Budd J, Doray B, et al. Twen- ty-year trends in the prevalence of Down syndrome and other trisomies in Europe: Impact of maternal age and prenatal screening. Eur J Hum Genet 2013;21:27–33.
  • 3. Pranpanus S, Keatkongkaew K, Suksai M. Utility of fetal facial mark- ers on a second trimester genetic sonogram in screening for Down syndrome in a high-risk Thai population. BMC Pregnancy Childbirth 2022;22:27.
  • 4. Vos FI, De Jong-Pleij EA, Bakker M, Tromp E, Pajkrt E, Kagan KO, et al. Nasal bone length, prenasal thickness, prenasal thickness-to-nasal bone length ratio and prefrontal space ratio in second- and third-trimester fe- tuses with Down syndrome. Ultrasound Obstet Gynecol 2015;45:211–6.
  • 5. Özdemir H, Kalaycı H, Yetkinel S, Çok T, Çoban G, Tarım E. The nomo- gram of prenasal thickness and nasal bone ratio and its relationship with nuchal fold in second-trimester fetal ultrasound. J Obstet Gynaecol Res 2018;44:1063–71.
  • 6. Bellini C, Rutigliani M, Boccardo FM, Bonioli E, Campisi C, Grillo F, et al. Nuchal translucency and lymphatic system maldevelopment. J Perinat Med 2009;37:673–6.
  • 7. Guis F, Ville Y, Vincent Y, Doumerc S, Pons JC, Frydman R. Ultrasound evaluation of the length of the fetal nasal bones throughout gestation. Ultrasound Obstet Gynecol 1995;5:304–7.
  • 8. Maymon R, Levinsohn-Tavor O, Cuckle H, Tovbin Y, Dreazen E, Wiener Y, et al. Second trimester ultrasound prenasal thickness combined with nasal bone length: A new method of Down syndrome screening. Prenat Diagn 2005;25:906–11.
  • 9. Vos FI, De Jong-Pleij EA, Ribbert LS, Tromp E, Bilardo CM. Three-di- mensional ultrasound imaging and measurement of nasal bone length, prenasal thickness and frontomaxillary facial angle in normal second- and third-trimester fetuses. Ultrasound Obstet Gynecol 2012;39:636– 41.
  • 10. Sonek J, Molina F, Hiett AK, Glover M, McKenna D, Nicolaides KH. Pre- frontal space ratio: Comparison between trisomy 21 and euploid fetuses in the second trimester. Ultrasound Obstet Gynecol 2012;40:293–6.
  • 11. Moreno-Cid M, Rubio-Lorente A, Rodríguez MJ, Bueno-Pacheco G, Tenías JM, Román-Ortiz C, et al. Systematic review and meta-analy- sis of performance of second-trimester nasal bone assessment in de- tection of fetuses with Down syndrome. Ultrasound Obstet Gynecol 2014;43:247–53.
  • 12. Agathokleous M, Chaveeva P, Poon LC, Kosinski P, Nicolaides KH. Me- ta-analysis of second-trimester markers for trisomy 21. Ultrasound Ob- stet Gynecol 2013;41:247–61.
  • 13. Tournemire A, Groussolles M, Ehlinger V, Lusque A, Morin M, Benevent JB, et al. Prenasal thickness to nasal bone length ratio: Effectiveness as a second or third trimester marker for Down syndrome. Eur J Obstet Gynecol Reprod Biol 2015;191:28–32.
  • 14. De Jong-Pleij EA, Vos FI, Ribbert LS, Pistorius LR, Tromp E, Bilardo CM. Prenasal thickness-to-nasal bone length ratio: A strong and simple second- and third-trimester marker for trisomy 21. Ultrasound Obstet Gynecol 2012;39:185–90.
  • 15. Yang X, Zhen L, Pan M, Han J, Li D, Liao C. PT/NBL ratio assessment at mid-trimester in prenatal screening for Down syndrome in a Chinese population. J Matern Fetal Neonatal Med 2014;27:1860–3.
  • 16. International Society of Ultrasound in Obstetrics and Gynecology, Car- valho JS, Allan LD, Chaoui R, Copel JA, DeVore GR, et al. ISUOG Prac- tice Guidelines (updated): Sonographic screening examination of the fetal heart. Ultrasound Obstet Gynecol 2013;41:348–59.
  • 17. Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL, et al. Practice guidelines for performance of the rou- tine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol 2011;37:116–26.
  • 18. Maymon R, Ushakov F, Waisman D, Cuckle H, Tovbin Y, Herman A. A model for second-trimester Down syndrome sonographic screening based on facial landmarks and digit length measurement. Ultrasound Obstet Gynecol 2006;27:290–5.
  • 19. Szabó A, Szili K, Szabó JT, Sikovanyecz J, Isaszegi D, Horváth E, et al. Nasal bone length: Prenasal thickness ratio: A strong 2D ultrasound marker for Down syndrome. Prenat Diagn 2014;34:1139–45.
  • 20. Persico N, Borenstein M, Molina F, Azumendi G, Nicolaides KH. Pre- nasal thickness in trisomy-21 fetuses at 16-24 weeks of gestation. Ultra- sound Obstet Gynecol 2008;32:751–4.
  • 21. Manegold-Brauer G, Bourdil L, Berg C, Schoetzau A, Gembruch U, Geipel A. Prenasal thickness to nasal bone length ratio in normal and trisomy 21 fetuses at 11-14 weeks of gestation. Prenat Diagn 2015;35:1079–84.
APA AKALIN M, KARA M, Akalın E, gök k, kul g, ESIM BÜYÜKBAYRAK E (2022). Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. , 207 - 212. 10.14744/zkmj.2022.24865
Chicago AKALIN MÜNİP,KARA Merve,Akalın Emine Eda,gök koray,kul gizem,ESIM BÜYÜKBAYRAK ESRA Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. (2022): 207 - 212. 10.14744/zkmj.2022.24865
MLA AKALIN MÜNİP,KARA Merve,Akalın Emine Eda,gök koray,kul gizem,ESIM BÜYÜKBAYRAK ESRA Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. , 2022, ss.207 - 212. 10.14744/zkmj.2022.24865
AMA AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. . 2022; 207 - 212. 10.14744/zkmj.2022.24865
Vancouver AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. . 2022; 207 - 212. 10.14744/zkmj.2022.24865
IEEE AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E "Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye." , ss.207 - 212, 2022. 10.14744/zkmj.2022.24865
ISNAD AKALIN, MÜNİP vd. "Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye". (2022), 207-212. https://doi.org/10.14744/zkmj.2022.24865
APA AKALIN M, KARA M, Akalın E, gök k, kul g, ESIM BÜYÜKBAYRAK E (2022). Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. Zeynep Kamil medical journal (Online), 53(4), 207 - 212. 10.14744/zkmj.2022.24865
Chicago AKALIN MÜNİP,KARA Merve,Akalın Emine Eda,gök koray,kul gizem,ESIM BÜYÜKBAYRAK ESRA Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. Zeynep Kamil medical journal (Online) 53, no.4 (2022): 207 - 212. 10.14744/zkmj.2022.24865
MLA AKALIN MÜNİP,KARA Merve,Akalın Emine Eda,gök koray,kul gizem,ESIM BÜYÜKBAYRAK ESRA Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. Zeynep Kamil medical journal (Online), vol.53, no.4, 2022, ss.207 - 212. 10.14744/zkmj.2022.24865
AMA AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. Zeynep Kamil medical journal (Online). 2022; 53(4): 207 - 212. 10.14744/zkmj.2022.24865
Vancouver AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye. Zeynep Kamil medical journal (Online). 2022; 53(4): 207 - 212. 10.14744/zkmj.2022.24865
IEEE AKALIN M,KARA M,Akalın E,gök k,kul g,ESIM BÜYÜKBAYRAK E "Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye." Zeynep Kamil medical journal (Online), 53, ss.207 - 212, 2022. 10.14744/zkmj.2022.24865
ISNAD AKALIN, MÜNİP vd. "Reference ranges of nasal bone length, pre-nasal thickness, and pre-nasal thickness-to-nasal bone length ratio in low-risk pregnant women: A retrospective and cohort study from Türkiye". Zeynep Kamil medical journal (Online) 53/4 (2022), 207-212. https://doi.org/10.14744/zkmj.2022.24865